Tribal Member Health Plan Information

In 2015, the Wichita
Executive Committee developed a tribal member health care plan
to provide access to quality medical, dental, and vision care for
all Tribal Members. Many of our members have no health
insurance, and those of us who do have insurance find that the high
deductibles and co-pays are often the reason we delay needed
healthcare.

The Tribal Member Plan meets the specific needs of all our
Tribal Members, regardless of age, residence or existing health
conditions. The Plan gives special consideration to the
unique needs of infants, children, working age adults, and
elders. The Plan benefits are unlike any "standard" insurance
products. It is a Native American benefit plan developed by
Native Americans for Native Americans.

The Wichita Executive Committee unanimously approved the Tribal
resolution authorizing the implementation of the Wichita and
Affiliated Tribes Tribal Member Health Plan 2016, 2017 and
2018.

UPDATE EFFECTIVE DEC. 13,
2018:

The WEC increased the dental coverage from $400 to
$500 effective Jan. 1, 2019. This is the only change to the 2019
plan. No tribal member will have to apply for a new card if they
are already enrolled in the program and already have their
card.

We believe that the plan will grow to cover more and more
benefits in higher amounts in the coming years. This
plan will only be allowed to cover enrolled members of the Wichita
and Affiliated Tribes.

Hospice care and hospice supplemental coverage for end of life
final expenses

Home health nursing care to help our elders who are homebound
due to illness

Skilled nursing facility care

Prescription drug benefits for all ages. This includes our
elders who are on Medicare.

Dental benefits for all Tribal Members young and old

Vision care benefits

Each Tribal Member receives his or her own
personalized health care identification card that guarantees access
to medical, dental and vision care at any provider without
complicated paper work or extended delays. The identification
card works the same as any health insurance card. Our Tribal
Member Health Benefit Plan identification card insures "access" to
care when we need it, wherever we choose to go.
Networks have been set up all over the country and even out of the
country to help make our dollars stretch. This creates minimal
out of pocket expense.

Each enrolled tribal member will be enrolled in one of the
following plans:

Plan A

This is for tribal members who have no health care coverage at
all.

In Network, $20 copay for Physician Office Visits

Emergency Room is a $100 copay

Prescription Copays: $0 Generic. $25 Name Brand
Prescriptions (up to $500 each year per member).

90% of most other services without a deductible.

Plan B

This is for tribal members who already have insurance. This
includes Group Health Plans, Medicare, Medicaid or any other type
of health insurance coverage already taken.

In Network, no copay for Physician Office Visits

Emergency Room $25 copay

Prescriptions: Copays $0 For Prescription balances not paid by
the Primary Insurance Payment (up to $500 each year per
member).

All other services pay at 100 percent in network to the plan
maximum after the primary coverage has paid.

Prescription Drugs

RX is limited to $500 per
Member per benefit year.

Vision Insurance

This will be paid through the VSP network with the
following:

One Eye Exam every 12 months. Frames or Lenses every 12 months
paid at 100% up to $250.

Dental Insurance

Pays 100% for teeth cleaning, x-rays and twice yearly check
ups.

Basic services such as fillings will be paid at 90%

Major services such as crowns will be paid at 80%

All services are subject to a total of $500 per member per
year (New for 2019)

End of Life Expenses Benefit

Hospice Care

End of Life Home Care

All expenses will be paid directly to the vendor providing the
services.